Change in health status in COPD: a seven-year follow-up cohort study

Sundh, Josefin; Montgomery, Scott; Hasselgren, Mikael; Kämpe, Mary; Janson, Christer; Ställberg, Björn; Lisspers, Karin

doi:10.1038/npjpcrm.2016.73

Cited by 17 publications

(14 citation statements)

References 35 publications

(45 reference statements)

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“…Either weak or no correlations among symptom domain, mental domain, and post-bronchodilator FEV1% predicted were observed in previous studies [30][31][32]. Our study also revealed that underweight was independently associated with higher score on the total CCQ and mental domain, which was consistent with the results of Sundh et al [8,11]; in addition, BMI < 25 kg/m 2 was significantly associated with lower health-related quality of life assessed by CCQ in a prospective study with 7 years of follow-up [33].…”

Section: Discussionsupporting

confidence: 92%

Determinants of Clinical COPD Questionnaire in Patients with COPD: A Cross-Sectional Observational Study

Zhou¹,

Zhou²,

Peng³

et al. 2020

Respiration

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Background: The Clinical COPD Questionnaire (CCQ) has been suggested by the Global Initiative of Chronic Obstructive Lung Disease (GOLD) as a comprehensive symptom measurement tool, which helps to classify patients in order to direct pharmacological treatment. Therefore, it is essential to understand its determinants. Objectives: To identify the determinants of the overall CCQ score and scores of its 3 subdomains among chronic obstructive pulmonary disease (COPD) patients from China. Methods: A total of 1,241 COPD patients in the outpatient department of the Second Xiangya Hospital in China were recruited. Basic information and clinical data were collected. Differences in the GOLD categories based on Modified Medical Research Council Dyspnea Scale (mMRC), COPD Assessment Test (CAT), and CCQ were compared. Multiple linear regression analyses were performed to evaluate determinant factors of the total CCQ and subdomain scores. Results: The total CCQ and/or separate domain scores significantly differed with sex, age, BMI, smoking status, biomass fuel exposure, exacerbation frequency, mMRC, CAT, and GOLD grades and groups. Subjects with asthma-COPD overlap (ACO) had worse health status based on CCQ than those with COPD alone. As for the 16 subgroups based on GOLD 2017, statistical differences in the total CCQ and functional domain scores were found among subgroups 1A-4A, 1B-4B, and 1D-4D. The mMRC classified much more patients into more symptom groups than CAT and CCQ. No significant difference was observed in the GOLD categories between the CAT and CCQ (cut point = 1.5). Multiple linear regression analysis showed that smoking status, underweight, ACO, post-bronchodilator FEV1% predicted < 50%, exacerbation history, and mMRC were independently associated with the total CCQ score. Only 3 variables were significantly associated with the symptom domain: ACO, exacerbations, and mMRC; for the functional domain, age ≥75 years, ACO, post-bronchodilator FEV1% predicted < 50%, exacerbation history, and mMRC were significant; female sex, underweight, frequent exacerbations (≥2), and mMRC were significantly associated with higher scores in the mental do

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Section: Discussionsupporting

confidence: 92%

Determinants of Clinical COPD Questionnaire in Patients with COPD: A Cross-Sectional Observational Study

Zhou¹,

Zhou²,

Peng³

et al. 2020

Respiration

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“…Younger patients experienced significantly worse health status and dyspnea compared with elderly [5,73]. However, older age has also been associated with worse health status [5,14]. In the present study, MCID estimates were larger for improvement and smaller for deterioration in elderly, although not all significant.…”

Section: Gender Age and Comorbiditiesmentioning

confidence: 46%

“…Many factors may impact health status in COPD, including the number and severity of exacerbations [8e10]; the disease severity defined according to the Global initiative for Obstructive Lung Disease (GOLD) spirometry classification [5,9e12]; the patient's gender and age [5,8e10,13e15]; and the amount of comorbidities [12]. Moreover, the baseline score may also be predictive of (worsening) health status [11,14].…”

Section: Introductionmentioning

confidence: 99%

Baseline health status and setting impacted minimal clinically important differences in COPD: an exploratory study

Alma

Jong

Jelusic

et al. 2019

Journal of Clinical Epidemiology

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Objectives: Minimal clinically important differences (MCIDs) are used as fixed numbers in the interpretation of clinical trials. Little is known about its dynamics. This study aims to explore the impact of baseline score, study setting, and patient characteristics on health status MCIDs in chronic obstructive pulmonary disease (COPD). Study Design and Setting: Baseline and follow-up data on the COPD Assessment Test (CAT), Clinical COPD Questionnaire (CCQ), and St. George's Respiratory Questionnaire (SGRQ) were retrospectively analyzed from pulmonary rehabilitation (PR) and routine clinical practice (RCP). Anchor-and distribution-based MCID estimates were calculated and tested between settings, gender, age, Global initiative Funding: The main RIMTCORE trial (#DRKS00004609) was funded by the Deutsche Rentenversicherung, Germany. The Dutch observational study on COPD health status in routine clinical practice (MCID study) as well as the current combined retrospective analysis of both studies received financial support from the Junior Scientific Masterclass (JSM) as part of the

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“…When adjusting for spirometric stage of COPD, deteriorated HRQoL was found to be predicted by increasing dyspnea, depression/anxiety, an increasing number of exacerbations, and decreased exercise capacity [6]. Other signs of deteriorating COPD disease are disabling breathlessness [7] and low body mass index [8]. …”

Section: Introductionmentioning

confidence: 99%

Influences of patient education on exacerbations and hospital admissions in patients with COPD – a longitudinal national register study

Henoch

Ekberg-Jansson²

2018

European Clinical Respiratory Journal

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Introduction: Chronic obstructive pulmonary disease (COPD) contributes to impaired health-related quality of life (HRQoL). Patient education and smoking cessation programs are recommended to reduce the number of exacerbations and hospitalizations, but the effects of such programs have yet to be explored in larger samples. Objective: The aim was to explore the longitudinal effects of patient education and smoking cessation programs on exacerbations and hospital admissions in patients with COPD. Design: This is a register study where data from the Swedish National Airway Register, including 20,666 patients with COPD, were used. Baseline measures of demographic, disease-related, and patient-reported variables were compared with a follow-up, 10–30 months after baseline. Descriptive statistics and changes between baseline and follow-up were calculated. Results: Comparing those not participating in education programs to those who did, HRQoL deteriorated significantly between baseline and follow-up in non-participants; there was no change in either exacerbations or hospitalizations in either group; there was a significant difference in baseline HRQoL between the two, and, when controlling for this, there was no significant change (p = 0.73). Patients who participated in smoking cessation programs were younger than the non-participants; mean 66.0 (standard deviations (SD) 7.8) vs. mean 68.1 (SD 8.8), p = 0.006. Among participants in smoking cessation programs, the proportion with continued smoking decreased significantly, from 76% to 66%, p < 0.001. Exacerbations at follow-up were predicted by FEV1% of predicted value and exacerbations at baseline. Hospital admissions at follow-up were predicted by baseline FEV1% of predicted value and exacerbations at baseline. Conclusions: To prevent exacerbations and hospital admissions, treatment and prevention must be prioritized in COPD care. Patient education and smoking cessation programs are beneficial, but there is a need to combine them with other interventions.

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Change in health status in COPD: a seven-year follow-up cohort study

Cited by 17 publications

References 35 publications

Determinants of Clinical COPD Questionnaire in Patients with COPD: A Cross-Sectional Observational Study

Determinants of Clinical COPD Questionnaire in Patients with COPD: A Cross-Sectional Observational Study

Baseline health status and setting impacted minimal clinically important differences in COPD: an exploratory study

Influences of patient education on exacerbations and hospital admissions in patients with COPD – a longitudinal national register study

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